When you attend a first aid or CPR course you might ask yourself, “if I start CPR, how long do I perform CPR for?” Where is that point where you realise CPR hasn’t worked? “How will I know that the person isn’t coming back to life?”

These are the questions I frequently hear on first aid courses, and they are excellent questions. The answer you would be given on a course is that you continue CPR until:

the person comes back to life

the paramedics arrive to take over from you

or you physically are completely unable to carry on

But why?

Why don’t you just give up after 10, 20, 30 minutes when it seems clear the person isn’t coming back to life?

The answer is that the goal of CPR is not really to bring a person back to life.

The goal of CPR is to delay brain injury and tissue death.

Our main goal in CPR as we push on the victims chest is to pump blood around the body, which carries oxygen to the brain. As long as oxygen is getting to the brain, the brain cells won’t die, and there is still a chance once the paramedics arrive with their equipment and medications, they will be able to revive the person. In a way, while we are performing CPR on a victim they are neither dead or alive. As soon as we stop they are effectually dead. This is why we keep going. This is why it doesn’t matter if we see no signs of life and perform CPR for 45 minutes before the ambulance arrive. As long as we perform the role of the heart and pump oxygen to the brain, there is still a chance the person can be revived.

If you were ever in the situation of needing to perform CPR on a person – just keep going! The current records of time CPR performed and the person surviving are in first place: a man in Minnesota 96 minutes! and runner up; a man in Washington 86 minutes CPR.

Many people face a first aid situation and find themselves unsure, “should I call the ambulance?”

Not knowing when or if you should call the ambulance may mean the difference between life or death.

In Australian you can call the ambulance on 000

The operator will ask for your address and details and then question you about the nature of your emergency. During this conversation the emergency services operator will be able to advise you of any first aid that you should be providing, they will even talk you through how to provide CPR if you have forgotten.

A general rule of thumb is: if the person is in too much pain to move them – call the ambulance. For example, if a person falls off a ladder and appears to have broken their arm, but they are not too distressed, you may choose to transport them to the emergency department, or doctors clinic in your car. However, if that person was unable to move at all without experiencing a great deal of pain – call the ambulance. The ambulance crew will be able to provide pain relief as they transport the person to seek medical care.

The other rule of thumb is: whenever a person is losing consciousness or is at risk of doing so. For example – any unconscious person must have an ambulance called for them.

If you suspect a person is having a heart attack, stroke, anaphylactic shock event, severe asthma attack, they are bleeding a large volume of blood, or they have very severe burns – call the ambulance. All of these events are beyond a first aider and require prompt medical intervention.

The decider is not only in how quick can you or the ambulance make it to the hospital, but also in what the ambulance crew can provide on route. You may think you can make it to the hospital pretty quickly, but you must ask yourself, what will you do if the casualty you are transporting goes unconscious in your car? You will not be able to provide pain relief, CPR, manage their airway or any suspected spinal injuries while you are driving the car. The paramedics can manage all of these events while they transport the person in the ambulance.

The question isn’t really how often do I need first aid? But rather, will I know first aid when I need it?

Studies show that just months after learning CPR most people have forgotten how to effectively provide CPR.

Crazy huh? That’s why the Australian Resuscitation Council recommend updating your CPR every 12 months. And in Australia, Provide First Aid is the qualification recommended for workplace first aiders, this is valid for 3 years.

Look, the last thing you want to do in an emergency is lose your head. If you panic you will not be able to assess the danger/safety of the whole situation first, and you may make yourself casualty number 2. The best way to ensure you are level headed enough to remain calm, is to update your first aid learning regularly, so it becomes second nature.

So. Would you remember how to do CPR today? How many other live saving techniques would you remember? Would you be able to keep cool in an emergency today?